We previously inspected this dental practice on 18 November 2013 and then again on 06 March 2014 when we found that there were a number of shortfalls in the way the provider managed cleanliness and infection control processes. These shortfalls related to the instrument decontamination arrangements and the provider's response to infection control monitoring. We judged that this had a minor impact on people using the service and required the provider to make further improvements.

We inspected the location once more on 17 June 2014 and found that significant improvements had been made and that people were protected from the risk of infection.

The decontamination facilities had been renovated and a dental nurse had been given lead responsibility for infection control. The provider had also employed independent consultants to assist them in identifying and implementing processes that improved the practice's cleanliness and hygiene.

There was a more rigorous approach to instrument decontamination so that the relevant Department of Health (DH) guidance was followed. The designated lead nurse for infection control had a thorough understanding of the DH guidance and of their role in monitoring effectiveness in this area.

When we previously inspected Hitchin Dental Practice on 18 November 2013 we found that the provider was not compliant with a number of regulations. There was no suitable information available to support staff in their knowledge of potential abuse or of local safeguarding procedures. The practice did not operate hygienically due to the risk of infection arising from some environmental shortfalls. The provider did not have an effective system to act on feedback or complaints from people and there was no effective infection control audit.

We inspected the service again on 06 March 2014 to consider improvements that the provider said they had made.

We found that people were protected from the risk of abuse because the provider had made arrangements to support staff with information and training about abuse and safeguarding procedures.

There were some shortfalls in the infection control arrangements and the instrument decontamination process which meant that people were not properly protected from the risk of infection. The infection control audit was ineffective in identifying shortfalls.

The provider had taken steps to capture and review feedback from people about the service and to take account of comments and complaints.

People were asked for their signed consent prior to care and treatment commencing. We looked at five people’s records and saw that they all included treatment plans signed by the person for each appointment attended.

Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. We looked at the records for five people who used the service. We saw that each file included an updated medical history, treatment plans, and X-rays. People we spoke with were positive about the care and treatment they received. One person told us, “They’re nice, we moved away but still travel to come here.”

We found that although the provider and staff working at the service had some awareness relating to safeguarding people from abuse, their knowledge was limited. Staff at the service had not attended training in relation to safeguarding people from abuse.

There were some systems in place to promote infection control. However, there were some areas of the environment that posed a risk to cleanliness and infection control.

The service had developed surveys to gain people’s feedback and they had a complaints policy in place. However, information received was not used in an effective way which ensured that they were monitoring and assessing the quality of the service.